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Definition and Role

Under the direction of the Assistant Director of Revenue Cycle – Revenue Recovery, the Medical Billing & Records Team Lead is responsible for the accurate and timely posting of insurance payments, contractual adjustments, and denials using both electronic and manual posting methods. In addition to billing responsibilities, this position leads and manages the daily operations of the Home Health billing team and Medical Records department, ensuring efficient workflows, compliance with documentation standards, and cross-functional collaboration to support revenue cycle integrity.

Job Responsibilities and Duties

• Oversee the day-to-day functions of the Home Health billing and Medical Records teams, including task assignment, performance tracking, and training.
• Ensure timely posting of miscellaneous, manual, and electronic payments to patient accounts using EFT (Electronic Funds Transfer), ERA (Electronic Remittance Advice), and other accepted methods.
• Export all 835 electronic payment files and prepare for posting; resolve edits and report issues accurately.
• Post non-EDI payments, contractual allowances, rejection codes, deductibles, and copayments.
• Obtain missing ERA/835/EOB documents from payer portals or by phone.
• Research and resolve unidentified payments and recoupments for accurate posting.
• Ensure all payments are posted to the practice management system within established timeframes (live checks within 24 hours, online credit card payments next business day, EFTs within 72 hours).
• Maintain a detailed payment receipt spreadsheet with batch totals, posting dates, and initials.
• Balance batches and generate transaction reports for daily reconciliation.
• Verify posting of all EFT deposits and scanned checks prior to month-end close.
• Identify and resolve credit balances and posting errors at time of entry.
• Monitor productivity and quality benchmarks for self and team, taking corrective action as needed.
• Support the processing of patient billing statements and accept payments when required.
• Maintain up-to-date spreadsheets and daily reports to ensure data accuracy and transparency.
• Collaborate with other Revenue Cycle teams and leadership to streamline billing and documentation workflows specific to Home Health services.
• Ensure compliance with medical record documentation standards and timely record management.
• Perform all other duties as assigned.

Qualifications

• A minimum of a High School Diploma preferred and two years of Medical Billing and Collection experience.
• Working knowledge of EOB’s, EFT’s, and ERA’s
• Knowledge of managed care contracts, Medicare, Medicaid, workers comp, and private insurance carriers
• Excellent attention to detail
• Proficient use of Microsoft Office applications (Word, Excel, Outlook)
• Outstanding interpersonal skills and great team player.
• Must be able to work independently with a high degree of self-initiative.
• Excellent problem-solving abilities.
• Ability to work well under pressure and adapt to changes in project priorities.
• Demonstrated understanding of medical terminology required.
• Knowledge of patient confidentiality and HIPAA regulations
• Knowledge of CPT, HCPCS, and ICD10 coding required.
• Knowledge of medical billing and collection practices
• Knowledge working with electronic health records (EHR/EMR) or healthcare related computer systems.
• Practices efficient methods for getting work done; strong ability to prioritize workload.

Physical Requirements

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

• While performing this job the employee is frequently required to sit, talk, and hear.
• The employee is occasionally required to walk, use hands and fingers to feel, handle, or operate objects, tools, or controls, and reach with hands and arms.
• The employee must occasionally lift and/or move objects weighing up to 25 pounds.
• Specific vision abilities required by this job include close vision and the ability to adjust and focus.
• Emotional/Psychological: Constant ability to make decisions and concentrate.